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Developing and sustaining evidence-based policy-making to reduce obesity in Fiji: The TROPIC project
Oral Abstracts
45
O090 Participants’ perceptions of a knowledge broking approach to facilitate the development of evidence-based policies to reduce obesity in Fiji Waqa 1,∗ ,
Mavoa 2 ,
Snowdon 1,2 ,
G. H. W. A. M. Moodie 3 , M. McCabe 4 , B. Swinburn 2,5
Raj 1 ,
1 CPOND
College of Medicine Nursing and Health Sciences, Fiji National University, Fiji 2 WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia 3 Deakin Health Economics, Faculty of Health, Deakin University, Melbourne, Australia 4 School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia 5 School of Population Nutrition and Global Health, University of Auckland, New Zealand Aim: Evidence-informed policy making (EIPM) is optimal when evidence-producers (researchers) and policy developers work collaboratively to ensure the use of the best available evidence. The TROPIC (Translational Research in Obesity Prevention in Communities) project examined the impact of knowledge broking on the use of obesity-related evidence in policy development in Fiji. Method: Knowledge brokers delivered a 12—18month tailored programme comprising workshops targeting EIPM skills and supported the development of evidence-informed policy briefs to reduce obesity. Participants negotiated policy topics and applied EIPM processes to formulate policy briefs. Mentoring for participants included one-to-one meetings, small-group discussions, email interactions and phone conversations. Semi-structured and structured interviews were used to examine participants’ (n = 32) and organisations’ (n = 6) perceptions of engagement processes that were used. Data were analysed descriptively and thematically. Results: Many participants believed that they had increased their skills in acquiring, assessing and adapting evidence, writing policy briefs and presenting evidence-based arguments to higher-level officers. Twenty policy briefs were presented to higher levels. Participants indicated that one-toone meetings, good resource materials and the informal environment developed by the team were very helpful. Perceived barriers to EIPM were lack of local evidence, time to develop evidence-informed briefs, and insufficient resources for accessing and managing evidence. Conclusion: The knowledge broking practical approach tailored to mentorship and skill development facilitated individual learning and team development. The success of this innovative
approach to promoting EIPM for obesity prevention suggests it could be used as a model to stimulate policy action in other Pacific countries. http://dx.doi.org/10.1016/j.orcp.2012.08.092 O091 Developing and sustaining evidence-based policymaking to reduce obesity in Fiji: The TROPIC project H. Mavoa 1,∗ , G. Waqa 2 , W. Snowdon 1,2 , R. Kremer 3 , M. Moodie 4 , M. Nadakuitavuki 2 , P. 5 1,6 McCabe , B. Swinburn 1 WHO
Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia 2 Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji 3 McCaughey Centre, The University of Melbourne, Melbourne, Australia 4 Deakin Health Economics, Deakin University, Melbourne, Australia 5 School of Psychology, Deakin University, Melbourne, Australia 6 School of Population Health, University of Auckland, New Zealand Aim: The Pacific TROPIC (Translation Research for Obesity Prevention in Communities) project aimed to build and sustain the use of evidence when developing policies in Fiji to reduce the high prevalence of obesity. Method: A three-phase programme delivered to four government and two non-government organisations comprised: (1) workshops targeting evidence-informed policy-making (EIPM) skills; (2) supported development of evidence-informed policy briefs to reduce obesity; and (3) building an organisational culture that supported EIPM. Phase 3 initiatives included: raising awareness of the need for EIPM to reduce obesity; supported development of policy units and policies requiring evidence use (policies-on-policy); and developing a critical mass of policy developers with EIPM skills. Semi-structured and structured interviews with individual participants (n = 42) and high level officers (n = 6) were analysed thematically. Results: Individual participants and high-level officers valued EIPM more following TROPIC, recognising that evidence-informed policies were both attainable and more likely to be endorsed. Two policy units and three policies-on-policy were developed. An Embedding Workshop facilitated inter-organisational networks with attendees recommending the: establishment of accredited EIPM
46
Oral Abstracts
courses; provision of adequate resources and high-level support for accessing evidence (infrastructure like internet access), development of evidence-informed briefs (time) and networking opportunities (within/between organisations); and greater recognition of EIPM expertise (key performance indicators [KPIs]; promotions). Conclusion: TROPIC has demonstrated that a country with limited capacity can embed EIPM into policy-making when a critical mass of policy developers have EIPM skills and there are adequate organisational/governmental structures, processes and support to embed EIPM in order to reduce obesity. http://dx.doi.org/10.1016/j.orcp.2012.08.093 O092 Body mass index and waist circumference as indicators of risk for non-communicable diseases in Pacific Islanders W. Snowdon 1 , M. Swinburn 2
Malakellis 2 , L.
Millar 2,∗ , B.
1 C-POND,
Fiji National University and Deakin University, Suva, Fiji 2 WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia Aim: Body mass index (BMI) and waist circumference (WC) are widely used tools to identify risk of non-communicable diseases (NCDs). Research has indicated that the risk relationships differ by ethnicity. The aim of this research was to identify the BMI and WC action points with the highest sensitivities and specificities for identifying risk of NCDs in Pacific Islanders. Method: In this study, data from chronic disease surveys in Fiji, Nauru, Solomon Islands and Wallis and Futuna were merged. All surveys included anthropometric measurements, fasting blood glucose and total cholesterol and blood pressure measurement. ROC curve analysis (roctab) was used to assess the optimal cut or action points for each predictor variable with respect to each outcome factor. The analysis was performed separately for Melanesians and the combined sample of Polynesians/Micronesians by sex and by age subgroups. Results: The combined dataset was 8642, of which 55% were women and 70% were Melanesians. Action points for BMI of 28.6 for men and 29.6 for women at a regional level, and WC of 93.8 cm had the highest specificity and sensitivity for identifying two or more risk factors. For Melanesians the values were 24.9 and 28.6 kg/m2 for BMI, respec-
tively, and for WC 89.6 cm for women and 85.6 cm for men. Conclusion: Action points for non-Melanesians were higher than for Melanesians, and region-wide values are therefore inappropriate, and gender specific action points may also be relevant. Further research is needed, and also consideration of the practical implications of multiple action points. http://dx.doi.org/10.1016/j.orcp.2012.08.094 O093 Adolescents’ dietary patterns in Fiji and relationship with standardized BMI J. Wate 1,2,∗ , W. Snowdon 2,3 , L. Millar 3 , M. Nichols 3,5 , H. Mavoa 3 , A. Kama 4 , R. Goundar 1,2 , B. Swinburn 3,6 1 School
of Social and Health Development, Deakin University, Australia 2 Pacific Centre for Prevention of Obesity and Noncommunicable Diseases, Fiji National University, Fiji 3 WHO Collaborating Centre for Obesity Prevention, Deakin University, Australia 4 Fiji National Food and Nutrition Centre, Fiji 5 British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, UK 6 Population Nutrition and Global Health, University of Auckland, New Zealand Aim: To identify important dietary patterns of adolescents in peri-urban Fiji and their relationships with BMI-z. Method: This study utilised baseline measurements from the Pacific OPIC (Obesity Prevention In Communities) project. The sample comprised 6871 students aged 13—18 years from 18 secondary schools in Viti Levu, Fiji. Participants completed a questionnaire that included diet-related variables: height and weight were measured. Descriptive statistics and regression analyses examined the associations between dietary patterns and BMI-z. Results: In total, 24% of adolescents were overweight/obese, with a higher prevalence among Indigenous Fijians and females. Almost all adolescents reported frequent consumption of sugar sweetened beverages (SSB) (90%) and low intake of fruit and vegetables (74%). Over a quarter frequently consumed takeaways for dinner, high fat or salty snacks, or confectionery after school. Nearly one quarter reported irregular breakfast (24%) and lunch (24%) consumption on school days, while relatively few students (13%) ate fried foods after school. IndoFijians were generally more likely than
45
O090 Participants’ perceptions of a knowledge broking approach to facilitate the development of evidence-based policies to reduce obesity in Fiji Waqa 1,∗ ,
Mavoa 2 ,
Snowdon 1,2 ,
G. H. W. A. M. Moodie 3 , M. McCabe 4 , B. Swinburn 2,5
Raj 1 ,
1 CPOND
College of Medicine Nursing and Health Sciences, Fiji National University, Fiji 2 WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia 3 Deakin Health Economics, Faculty of Health, Deakin University, Melbourne, Australia 4 School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia 5 School of Population Nutrition and Global Health, University of Auckland, New Zealand Aim: Evidence-informed policy making (EIPM) is optimal when evidence-producers (researchers) and policy developers work collaboratively to ensure the use of the best available evidence. The TROPIC (Translational Research in Obesity Prevention in Communities) project examined the impact of knowledge broking on the use of obesity-related evidence in policy development in Fiji. Method: Knowledge brokers delivered a 12—18month tailored programme comprising workshops targeting EIPM skills and supported the development of evidence-informed policy briefs to reduce obesity. Participants negotiated policy topics and applied EIPM processes to formulate policy briefs. Mentoring for participants included one-to-one meetings, small-group discussions, email interactions and phone conversations. Semi-structured and structured interviews were used to examine participants’ (n = 32) and organisations’ (n = 6) perceptions of engagement processes that were used. Data were analysed descriptively and thematically. Results: Many participants believed that they had increased their skills in acquiring, assessing and adapting evidence, writing policy briefs and presenting evidence-based arguments to higher-level officers. Twenty policy briefs were presented to higher levels. Participants indicated that one-toone meetings, good resource materials and the informal environment developed by the team were very helpful. Perceived barriers to EIPM were lack of local evidence, time to develop evidence-informed briefs, and insufficient resources for accessing and managing evidence. Conclusion: The knowledge broking practical approach tailored to mentorship and skill development facilitated individual learning and team development. The success of this innovative
approach to promoting EIPM for obesity prevention suggests it could be used as a model to stimulate policy action in other Pacific countries. http://dx.doi.org/10.1016/j.orcp.2012.08.092 O091 Developing and sustaining evidence-based policymaking to reduce obesity in Fiji: The TROPIC project H. Mavoa 1,∗ , G. Waqa 2 , W. Snowdon 1,2 , R. Kremer 3 , M. Moodie 4 , M. Nadakuitavuki 2 , P. 5 1,6 McCabe , B. Swinburn 1 WHO
Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia 2 Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji 3 McCaughey Centre, The University of Melbourne, Melbourne, Australia 4 Deakin Health Economics, Deakin University, Melbourne, Australia 5 School of Psychology, Deakin University, Melbourne, Australia 6 School of Population Health, University of Auckland, New Zealand Aim: The Pacific TROPIC (Translation Research for Obesity Prevention in Communities) project aimed to build and sustain the use of evidence when developing policies in Fiji to reduce the high prevalence of obesity. Method: A three-phase programme delivered to four government and two non-government organisations comprised: (1) workshops targeting evidence-informed policy-making (EIPM) skills; (2) supported development of evidence-informed policy briefs to reduce obesity; and (3) building an organisational culture that supported EIPM. Phase 3 initiatives included: raising awareness of the need for EIPM to reduce obesity; supported development of policy units and policies requiring evidence use (policies-on-policy); and developing a critical mass of policy developers with EIPM skills. Semi-structured and structured interviews with individual participants (n = 42) and high level officers (n = 6) were analysed thematically. Results: Individual participants and high-level officers valued EIPM more following TROPIC, recognising that evidence-informed policies were both attainable and more likely to be endorsed. Two policy units and three policies-on-policy were developed. An Embedding Workshop facilitated inter-organisational networks with attendees recommending the: establishment of accredited EIPM
46
Oral Abstracts
courses; provision of adequate resources and high-level support for accessing evidence (infrastructure like internet access), development of evidence-informed briefs (time) and networking opportunities (within/between organisations); and greater recognition of EIPM expertise (key performance indicators [KPIs]; promotions). Conclusion: TROPIC has demonstrated that a country with limited capacity can embed EIPM into policy-making when a critical mass of policy developers have EIPM skills and there are adequate organisational/governmental structures, processes and support to embed EIPM in order to reduce obesity. http://dx.doi.org/10.1016/j.orcp.2012.08.093 O092 Body mass index and waist circumference as indicators of risk for non-communicable diseases in Pacific Islanders W. Snowdon 1 , M. Swinburn 2
Malakellis 2 , L.
Millar 2,∗ , B.
1 C-POND,
Fiji National University and Deakin University, Suva, Fiji 2 WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia Aim: Body mass index (BMI) and waist circumference (WC) are widely used tools to identify risk of non-communicable diseases (NCDs). Research has indicated that the risk relationships differ by ethnicity. The aim of this research was to identify the BMI and WC action points with the highest sensitivities and specificities for identifying risk of NCDs in Pacific Islanders. Method: In this study, data from chronic disease surveys in Fiji, Nauru, Solomon Islands and Wallis and Futuna were merged. All surveys included anthropometric measurements, fasting blood glucose and total cholesterol and blood pressure measurement. ROC curve analysis (roctab) was used to assess the optimal cut or action points for each predictor variable with respect to each outcome factor. The analysis was performed separately for Melanesians and the combined sample of Polynesians/Micronesians by sex and by age subgroups. Results: The combined dataset was 8642, of which 55% were women and 70% were Melanesians. Action points for BMI of 28.6 for men and 29.6 for women at a regional level, and WC of 93.8 cm had the highest specificity and sensitivity for identifying two or more risk factors. For Melanesians the values were 24.9 and 28.6 kg/m2 for BMI, respec-
tively, and for WC 89.6 cm for women and 85.6 cm for men. Conclusion: Action points for non-Melanesians were higher than for Melanesians, and region-wide values are therefore inappropriate, and gender specific action points may also be relevant. Further research is needed, and also consideration of the practical implications of multiple action points. http://dx.doi.org/10.1016/j.orcp.2012.08.094 O093 Adolescents’ dietary patterns in Fiji and relationship with standardized BMI J. Wate 1,2,∗ , W. Snowdon 2,3 , L. Millar 3 , M. Nichols 3,5 , H. Mavoa 3 , A. Kama 4 , R. Goundar 1,2 , B. Swinburn 3,6 1 School
of Social and Health Development, Deakin University, Australia 2 Pacific Centre for Prevention of Obesity and Noncommunicable Diseases, Fiji National University, Fiji 3 WHO Collaborating Centre for Obesity Prevention, Deakin University, Australia 4 Fiji National Food and Nutrition Centre, Fiji 5 British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, UK 6 Population Nutrition and Global Health, University of Auckland, New Zealand Aim: To identify important dietary patterns of adolescents in peri-urban Fiji and their relationships with BMI-z. Method: This study utilised baseline measurements from the Pacific OPIC (Obesity Prevention In Communities) project. The sample comprised 6871 students aged 13—18 years from 18 secondary schools in Viti Levu, Fiji. Participants completed a questionnaire that included diet-related variables: height and weight were measured. Descriptive statistics and regression analyses examined the associations between dietary patterns and BMI-z. Results: In total, 24% of adolescents were overweight/obese, with a higher prevalence among Indigenous Fijians and females. Almost all adolescents reported frequent consumption of sugar sweetened beverages (SSB) (90%) and low intake of fruit and vegetables (74%). Over a quarter frequently consumed takeaways for dinner, high fat or salty snacks, or confectionery after school. Nearly one quarter reported irregular breakfast (24%) and lunch (24%) consumption on school days, while relatively few students (13%) ate fried foods after school. IndoFijians were generally more likely than